Introduction to peanuts as an infant

Around 15 million Americans are affected by food allergy that can be potentially life-threatening with about one in every 13 children having a food allergy (Food Allergy Research & Education, n.d.). Allergies are becoming more prevalent and worry for dietitians to become more aware of how to deal with it and how to decrease the risk of developing a severe allergy, like peanuts. Learning Early about Peanut Allergy (LEAP) trial was the first randomized trial to study early allergen introduction as a preventive strategy (Du Toi et al., 2015). They randomized 640 children between 4-11 months of age with severe eczema, egg allergy or both to either consume or avoid peanut containing foods until 60 months of age. The results showed a prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group. The results showed that the group who was introduced to peanuts early in age, had a lower prevalence of developing a peanut allergy. However, that does not mean they will not development a peanut allergy in the future, further studies need to be done on how to continue to not develop a peanut allergy (Du Toi et al., 2015).

The National Institute of Allergy and Infectious Disease and the American Academy of Allergy, Asthma & Immunology with 24 other organizations issued an addendum to its clinical guidelines of the 2010 Guidelines for the Diagnosis and Management of Food Allergy in the United States (American Academy of Allergy Asthma & Immunology [AAAAI], 2017). They now recommend that children be introduced to peanuts early in life before 12 months of age. However, parents of children with extremely high risk of developing allergies should consult with a health care professional before introducing peanuts and should be excluded during pregnancy and lactating mothers according to clinical guidelines (AAAI, 2017). High risk babies could be those who have a family history of peanut allergies or have a severe case of eczema, asthma, or have a severe allergy to eggs. Health care professional will determine the appropriate approach to food allergies by individualizing each case. Babies should never be feed a whole peanut due to chocking hazards but adding hot water to some peanut butter to create a puree is an adequate texture for a baby to consume. Introducing peanuts at an allergy age can help reduce developing a peanut allergy as well as prevent one from happening in the future by being aware of it ahead of time and avoiding it completely. 

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Food Allergy Research & Education. (n.d.) What is food allergy? Retrieved from https://www.foodallergy.org/life-with-food-allergies/food-allergy-101/what-is-a-food-allergy

Du Toi, G, Roberts, G., Sayre, P., Bahnson, H., Radulovic, S., Santos, A.,…& Brough, H. (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England Journal of Medicine, 372(9), 803-813. http://www.nejm.org/doi/full/10.1056/NEJMoa1414850

American Academy of Allergy Asthma & Immunology. (2017). Newly issued clinical guidelines from the NIAID recommend early peanut introduction, not avoidance. Retrieved from https://www.aaaai.org/about-aaaai/newsroom/news-releases/early-peanut-introduction

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